Life After Miscarriage: On Progesterone and Off My Rocker

I’ve been taking my progesterone pills for a week now. My face looks like a war zone, my bowels are in distress, and I’m pretty sure that a nitroglycerin plant could explode just outside my bedroom and I wouldn’t notice. I have a window of about 45 minutes between taking the pill and entering into a coma. On the plus side, I’m getting some great sleep.

Waking up the next day is a bit of a challenge and I think the extra hormones are eating brain cells because I left the pill bottle in my gym bag and left the gym bag in my car. If you want to know what I found when I opened the bottle that night, put a few jellybeans in the microwave for thirty seconds.

The next day, I sheepishly showed the pharmacist my ‘whoops.’ Her eyes popped out of her head and she said, “Wow. Oh. Hmmm.” Thanks lady. Yeah. I know I’m supposed to keep the pills in a cool dark place.

I watched her put the melted, rubbery yellow hunk in the palm of her hand and take it to the back to find out if they could replace the prescription with the ‘damaged’ feature of my insurance plan. You would have though she was carrying a tiny rhinoceros in the palm of her hand by the reactions of the staff in the back. Through the glass, I saw raised eyebrows and confused faces. Seriously guys. I can’t be the first person to have done this.  I’ve been really careful with my replacement pills, especially since I had to pay full price for half the pills.

I have three more days with this round. Then we wait for the magic to happen. Supposedly, my body will recognize the rapid decline in the hormone and Aunt Flo will show up. From there, we wait until cycle day 21. On that day, I run to the doctor without passing go and get my blood drawn. The results will tell us whether I am ovulating.

If I am, then I’ll continue taking the progesterone and hope that our routine — I mean our every-other -day romantic rendezvous’, result in a pregnancy.  If I’m not ovulating, then we have to make a decision about whether to start a course of egg-releasing pills.

Thanks a lot body. This is so much fun.

Life After Miscarriage: Reminders In The Mail

Some how, some way, Target found out I was pregnant. And so did Gerber Life, and American Baby Magazine, and Similac. Unfortunately, none of them got the memo that I’m not longer pregnant. My trip to the mailbox has become a daily reminder of that I should be getting ready to have a baby, not going to wine tastings and participating in adventure sports (I went whitewater kayaking a few weeks ago).

I got a huge ‘Celebrate Baby’ Target catalog today with a coupon that says “Free $20 gift card.” All I have to do is take the coupon and a printout of my registry to Guest Service at any Target store and they will give me a $20 gift card. Amazing! Oh what to do, what to do. Am I really going to pass up a $20 gift card when all I have to do is register for baby stuff?

This makes me wonder about registries. Could I start a baby registry and register for things that aren’t baby-related? What are the registry restrictions? I think at this point, I would register for the box of wine and a 500-count bottle of ibuprofen to get me through picking up the mail for the next several months. Then again, I could use the $20 gift card to buy a couple cheapie home pregnancy tests for future use.

What I really want to know is how do I get more of these catalogs with gift card offers on the back? I could create several registries under pseudonyms and rack up well over $100 in gift cards. This would take a little more work though. I’d probably have to monitor the customer service counter at Target for a few weeks to make sure I wasn’t always hitting the same guest services employee. More than one registry when I am so obviously not pregnant would probably raise a few eyebrows.

The Gerber Life Insurance Company offer isn’t nearly as much fun. The only thing I would actually get from participating in this offer is a Certificate of Welcome.  I actually have to fill out an application for my child though I don’t actually have to send any money now. There are big bold letters telling me “Send No Money!” My conscious won’t allow me to make up a name and date of birth, though it would be fun to write a prankster name like Carrie Oekey (karaoke).

Now American Baby magazine is actually very informative. I just read an article titled, “What No One Will Tell You About Being a Mom (But We Will!)” (June 2010) It scared the crap out of me. Heck, it actually made me a little happy I’m not pregnant. The article featured topics that start with “Why didn’t anyone tell me…” and end with “deafening howls can come out of such a tiny creature?” And “that no one mothers the mommy?” Or my personal favorite, “that discomfort does not end with childbirth?” Now this is the type of thing I don’t mind getting in the mail.

Hopefully you all understand that I’ve developed quite a snarky sense of humor from this experience. Oh wait. I had that before this experience.  Anyway…I suppose it’s a real sign of healing that rather than crying when I see the Target Baby catalog, my first thought is how to go about sticking it to Target and getting that $20 gift card!

Life After Miscarriage: Getting Ready to Try Again

It’s day 3 without caffeine. I’m getting a head start on cutting out the two cups of coffee. I’d rather have withdrawal symptoms now than when I’m pregnant.

I’ve been thinking about what I’ll do differently next time. Cutting out all caffeine is one thing. There are too many conflicting studies out there. Some say that less than 200 milligrams of caffeine is fine. Others say that any caffeine at all causes in increased risk for miscarriage. I’d rather not take any chances.

I’ve also started to take my prenatal vitamins like I was taking my birth control: religiously, not at the same time every day, and with a swig of beer occasionally.

Next time I’m pregnant, I won’t take any baths. Maybe the bath water was too hot. And I won’t go to spinning class. Maybe my heart rate was too high at one point.

Looking at this list, I should probably just start on bed rest the second I test positive. I can’t be too careful can I?

I’ll probably always wonder if I did something to cause the miscarriage. How could I not? Sure, I’ve read all the literature and I’ve heard my doctor say it too: “Most miscarriages that occur before 12 weeks are the result of a chromosomal abnormality and cannot be prevented.” Blah. Blah. Blah.

It would be so much easier to deal with if I could just pinpoint the cause. I’d know not to do “it” again and I’d feel so much better about my sense of control. It would be so much better to hear the doctor say: “Yeah. It was the coffee. Don’t do that again.” Then I would know! And I could control it. But how the heck can I control a chromosomal abnormality?

This pregnancy thing is such a crap shoot. And frankly, with what I know now, I can’t believe there are so many people in the world.

Life After Miscarriage: The First Period

It’s here! It’s here! It’s here! After a whopping 9.5 weeks, my period finally arrived. I haven’t been this thrilled about getting a period since I was 20 and forgot to use a back up method while I was on antibiotics (some antibiotics interfere with birth control pills).

Despite my best efforts to induce it weeks ago with parsley tea, red raspberry leaf tea, pomegranate juice, and a stint of wearing nothing but thongs, it took nine and half weeks.

I don’t think nine and a half weeks is average. From everything I read, and even from what my doctor said, four to six weeks is about average. Does that mean that I’m above average? Well, I’ve always tried to be a cut above the rest.

The minute Aunt Flo arrived, I texted my husband. “You might want to bring home a bottle of champagne. I finally got my period!” He was just as excited as I was though I think for different reasons. Getting my period meant that he didn’t have to make room in the refrigerator for the parsley bunches (parsley can supposedly bring on menstruation), or receive daily e-mail updates on possible signs of its impending arrival.

I think we both knew it was coming when I asked if it would be wrong to dip a spicy chicken wing in chocolate. Other than strange cravings and the worst breakout since I was about sixteen, I had no other warnings though and that’s what made the wait so frustrating.

Of course, now that it’s here there’s the little question of when we start trying again. One doctor told me to wait for three cycles and another told me to go for gold after one cycle. I guess the upside of waiting so long for a period was that we didn’t have to make any decisions about what we were going to do.

There’s a tremendous amount of energy that goes into thinking about these things. There’s logic on both sides of the coin. If we wait and I don’t conceive again right away, or worse, we have another miscarriage, I’m going to be angry that we waited. If we don’t wait, and I conceive, and we have another miscarriage, I’m going to be angry that we didn’t wait.

You’re probably thinking “Uh…isn’t it possible that you’ll conceive right away AND have a healthy full-term pregnancy?” Yes. It’s possible but so are the other scenarios.

Life After Miscarriage: Lessons Learned

I’ve been feeling much better lately. Really, I have.

I’ve been thinking about what I learned from this whole experience and I’ve come up with a few things:

Grief is like a tsunami. It comes suddenly and in huge waves. It completely drowns the heart and mind and then it recedes, slowly.  Eventually, things get back to normal but it takes time and you can’t rush it. And that takes me to my next learn.

Time really does heal. Yeah. It’s cliché and I wouldn’t have believed you two months ago if you would have said I would feel like myself in just eight short weeks.  But I do. I think the catch here is that you have to be willing to heal and, for me that meant finding out that you have to…

Trust the process. I’m still working on this one. Pregnancy is a forty-week process. Miscarriage is a process. The monthly menstrual cycle is a process. Grief is a process. Healing is a process. I’ve learned I can’t rush any of it. I’ve tried and it just leads to more anxiety.  Anxiety leads to suffering and here’s what I’ve learned about suffering…

Suffering is a choice. After this experience, I can distinguish between grief and suffering. Grief is what you feel when you lose something that meant a lot. Suffering is becoming a prisoner to grief. I can grieve my loss but I will not suffer from it or because of it because I deserve more.

If a woman in my life ever experiences a miscarriage, these are the things I would tell her. She wouldn’t believe me, of course, because it’s not something you can believe until you go through the process yourself. But I would tell her anyway because when you go through a miscarriage, you want to know that it will get better even when you simply can’t imagine anything but the pain of the loss.

While I’m sad I had to learn these lessons in this way, I’m grateful that I’ve been able to come away with something and I’m proud to say that I survived.

Life After Miscarriage: Eight Weeks Not Pregnant

Early June will mark 8 weeks since my miscarriage. Eight weeks was how long my baby lived inside of me. In eight weeks, nearly all the organs in my baby’s body had started forming.  Its eye lids were sealing shut. It had hands and arms, and legs. It had a beating heart. And then, it was gone.

So here I am, 8 weeks not-pregnant. It’s almost like a dream; something that I’m sure and certain seemed so real but there’s nothing that exists to prove it to me.  I would question whether it all happened, but the empty place in my heart tells me it did.

My best friend is well into the second trimester of her pregnancy. She is exactly where I would have been. She sent me a message the other day after hearing her baby’s heartbeat for the first time. When I opened the message I simultaneously had two reactions. The first was one of excitement for her; her first true sign that life exists inside. The other reaction was one of sheer shock.

Since the miscarriage, it hadn’t occurred to me that pregnancy ends in anything other than a miscarriage and here, in my life, written in a text message on my phone, was an example of how it does.  

That was a confronting moment and I spent a few seconds whimpering and trying to stop my face from contorting into the expression that ends with tears and gasping.

I couldn’t do it. I cried on my husband’s shoulder, soaking it with tears and begged him to help me understand why. “Why not us? Why not our baby’s heartbeat? Why did this happen?”

He didn’t have an answer. No one does and believe me I’ve asked: doctors, nurses, friends, and yes, God. The same thing I hear over, and over, and over again is “Everything happens for a reason.”

OK. I can buy it. I get it. It makes sense. But what’s the reason it happened to us? Answer me that and should I be fortunate enough to have a successful pregnancy, I’ll name my firstborn after you.

Exhibit 100E: Female Homosapien Post-Miscarriage

I never thought I’d be so anxious to get a period. Yes, you read it right: anxious, not eager.  I’m starting to get jumpy here. Before the pregnancy, I was regular to the hour. It was actually kind of creepy. Now, I’m on day 35 of Period Watch. Yep – it’s an official event with official lingo.

I’ve adopted some of the National Weather Center’s lingo to help liven up the waiting. “Watch” actually means, conditions are favorable though no actual signs have been spotted. “Warning” means that there’s been an actual sighting.

Indeed, conditions are favorable. It’s been more than 20 days without bleeding and my last ultrasound showed no remaining products of conception. Plus, I really, really, want to get it. What’s not favorable about that?

Getting old Aunt Flo will be the first sign that my body is back in business. The second sign will be getting another one within a reasonable time frame.

I feel a bit like I’ve become my own science experiment. Watching, waiting, observing; adding variables like vitamins and folic acid: “Let’s see what happens if I take these.” And then, subtracting other variables: “If I don’t wear a pad, and I wear white pants, will karmic forces intercede?”

Soon I’ll be sampling my own cervical mucus and comparing it to pictures on the internet. But hey, it’s in the name of science! Exhibit 100E: Female Homosapien post-miscarriage.

Come to think of it though, when you’re trying to have a baby, conception is really more science than it is romance. If you look for information on trying to conceive, then you’ll probably come across three of the most popular topics:

Temping: the process of monitoring your basal body temperature to detect the subtle rise indicating ovulation is imminent or occurring. A decline in temperature after a slight elevation usually indicates the egg was released and not fertilized. If the temperature stays elevated, it could indicate implantation of a fertilized egg.\

Cervical mucus: I wasn’t kidding when I said I was going to start sampling it. Otherwise known as CM, cervical mucus morphs throughout the month from sticky to creamy to slippery and thin like egg-whites. It’s the slippery thin stuff that helps sperm swim and when you see it, it’s time to get it on if you know what I mean.

Charting: the process of recording temperature and cervical mucus among other signs throughout your monthly cycle. There’s a whole system of checks, and circles, and squares and letters and morse code involved with charting (just kidding on the morse code part – but it’s almost as complex)

All of that is well beyond my reach at this time though. I’m still waiting for my monthly cycle to make an appearance for the first time since January.  I’ll give it two more weeks until I start to panic. In the meantime, I think I’ll go buy some white pants and see if I can tempt the universe.

Questions After Miscarriage: Where Do I Find Support?

Between social mediums like Facebook and Twitter and websites like Craigslist and MeetUp, connecting with people who have similar interests and experiences has never been easier. Don’t believe me? Head on over to Meetup.com and try this experiment. Search for “working moms.” There are more than 3000 groups worldwide that meet under that topic. Now try “stay at home moms.” More than 4000 groups meeting!

Try this same experiment with “pregnancy loss” and you’ll likely receive the same message I did: “Sorry, no matches found for ‘pregnancy loss’ within 100 miles of your zip code.” Well I’ll be darned.

Not having luck with finding local support groups, I decided to head to a bookstore to look for books about coping with pregnancy loss.

The woman at the service desk in Barnes and Noble looked nice enough and I thought I could trust her with my secret so I said, “I’m looking for books about miscarriage.” I waited for her to grimace or flinch under the weight of that awful word. I had imagined her look of pity. Instead, I got nothing. I might as well have asked her where I could find the dictionary section.

She led me to the back, far corner of the bookstore. I followed her thinking, “How appropriate. A corner where I can browse through my tears for the perfect book on how to cope with the loss of my unborn child.”

The section also had books about other taboo subjects like menopause and anxiety. We were able to find exactly one book. One. “Really?” I asked. “There’s no other section? Maybe near the family planning area?” She offered to go check the inventory while I stood there and scoured the shelf thinking maybe she missed it.

For all of the information on conception and pregnancy, there is a fraction of information available on the topic of miscarriage. A search for pregnancy books on Amazon yielded nearly 24,000 results. A search for miscarriage books yielded 901.

The woman came back and said, “I can order one for you.” I declined.

At home I logged into my local library website, something I was avoiding because I have overdue fines from the prenatal yoga DVDs I checked out and was late returning. The library carried a small selection of books (more than I thought they would considering it’s not a well-funded or large library). “Oh good,” I thought, clicking on the first title.

“Due on May 13,” flashed on the screen.

“What? Whaaaat?” I clicked on the next title. “Due on May 13.” The third title: “Due on May 13.”

The library had 3 books and they were checked out! There was a woman, somewhere in my locality, who had checked out these books. Where is she? Who is she? Will she be my friend?

Desperate for a connection, to hear from other women who have been through this experience, I continue to search for local support groups and to lurk on online pregnancy loss boards. I have what seems like thousands of questions. When? What did you do? How long did you? What did your doctor say? What were your HCG levels? How long did it take you to? How did you? Who did you? What did she say? What about?

I don’t know where I’ll find my answers, or my comfort for that matter. It just seems that I shouldn’t have to look so hard.

After Miscarriage: The Big Follow Up

I’m convinced that the universe is conspiring against me. The day I first found there was a problem with my pregnancy my doctor was delivering babies. The day I didn’t see a heartbeat on the ultrasound screen, my doctor was on vacation and my husband was en route to San Francisco for a business event. The day I actually had the miscarriage, my hubby was in Washington, DC.  When the nurse called to schedule my two-week follow up appointment, it made sense that she said, ‘Ohhh. Gosh. The week we need to get you in is the week the doctor is scheduled for jury duty.” Come on universe! Really?

I digress, however. Today, I want to share my follow-up appointment saga.

Because my doctor was out fulfilling her civic responsibilities (and for the record, “I have to deliver babies” is not a valid reason to be excused from jury duty in the great State of Ohio), I had to select, from among more than a dozen, another doctor in the practice. “Do you have a preference?” the scheduling nurse asked.

I requested the doctor a friend recommended and didn’t hold my breath for anything special. That’s why I was pleasantly surprised by the women who walked in the room and said, “It’s hard coming to our offices and seeing so many pregnant women and babies, isn’t it?”  

Let me be really honest here. Her compassion wasn’t unprovoked. The nurse who called me in from the waiting room had the gall to ask “How are you?”

Well, after sitting in a waiting room full of glowing women in various stages of pregnancy, I was undeniably not OK. Through gritted teeth, I basically told the nurse about how sucky my life is right now.  She was lucky to walk away without bruised shins.

I guess my reaction was a bit startling because she led me to a room right away and the doctor was knocking on my door within a matter of seconds. I can only imagine what the nurse must have said. Probably something along the lines of “We’ve got a situation in Room 2. Take your tranq gun.”

Wiping my eyes with the back of my hand and uncurling my lower lip, I nodded in acknowledgement of the doctor’s question and thought about apologizing for my emotional behavior. I decided against it and let her make the next move.

The doctor was blessedly calm. She’s what my friend would call ‘granola.’ You know. The type of person to wear Birkenstocks with socks and play an acoustic guitar after dinner and before reading Organic Gardening on her soy sheet set.  In other words, exactly what I needed. (By the way, I have no idea if this doctor wears Birkenstocks or gardens organically but I would be willing to bet yes.)

We chatted for a bit and she jotted down notes as I recounted the events that landed me in that room on that day. She answered all of my questions, did an internal exam, ordered blood work and said, “There’s no reason to wait if you want to try again. You can start with your next cycle.”

“Let me clarify,” I said. “You mean, as soon as I get my period, I can stop using protection?”

Nodding, she said, “Yes. Your next cycle.”

For the first time in weeks I smiled. I was overjoyed. “Thank you. Thank you for your time and your patience.” I hurried out of the room nearly knocking over the nurse I initially almost knocked out. I went to the lab to have my HCG (the pregnancy hormone) draw and then made the good news call to my husband.

The excitement of that visit lasted just over 24 hours. I got a call the next day from my doctor’s nurse. “Your HCG is still at 13. We need to make sure it gets to zero. Can you come back for more blood work in two weeks?”

I was devastated. I am devastated. How can this be? I’m not pregnant but the pregnancy hormone is still in my blood?

“It can take some women a long time to drop to zero,” the nurse explained over the phone.

“Well, what if it doesn’t drop?” I asked.

“We have no reason to believe it won’t,” she said. “We just like to make sure it gets to zero.”

Through more probing I was able to find out that some women require an “intervention” if the numbers don’t continue to fall. The nurse didn’t care to elaborate on what exactly an intervention entails. Left to my own imagination, I pictured a cold hospital room and machines that beep. I hope I don’t have to find out.

Dear Body: An Open Letter

Dear Body,

I’d like to talk with you about what you put me through over the past month. You see, I’m pretty upset with a certain sector we’ll call my reproductive system and so I thought I’d just get it off my chest by writing this letter.

I’ve always marveled at the way that you just knew what to do every month. I’ve always appreciated how punctual you were and really, how predictable. I mean, how can I argue when I know exactly when to expect my monthly cycle to start and end? You were so good about that, even when I took away your friend oral contraceptive. Of course, you did pout for about 45 days after I stopped taking the birth control, but then you decided to pull it together and we were regular.

I was quite pleased with your regularity because it meant that I could plan a little surprise for you. As you know, in February, I introduced a little friend of my husband’s to our good friend, little egg. The two immediately fell in love and snuggled right into the uterus.

Boy, I was so excited to find out that the two were getting along, even though their soiree upset some of my other body parts, like my digestive track who became depressed and slowed down, and my breasts who were quite sore. Nonetheless, I was more than happy to put up with their shenanigans because it meant that something wonderful was happening inside.

About 8 weeks in, I found out that our two small friends, though deeply settled inside me, were having a bit of an argument. Turns out, they were playing a game of “Go Fish” with their chromosomes and well, I don’t have the whole story, but apparently, they weren’t playing with a full deck. At some point, someone had had enough and decided to stop playing.

The problem for me is that I was really counting on these guys having a pretty good friendship. When I found out that they weren’t getting along, it sent me reeling. To make matters worse, the uterus was out to lunch. Even though our little friends quit playing together, the uterus didn’t kick them out! Can you believe it?

You know what happened next. I had to send in a bouncer called Misoprostal. He’s a pretty mean agent, but not as mean as dilation and curettage so I guess you’re pretty lucky I didn’t have to send him in!

Luckily, Misoprostal got everything out of the uterus. I had a good look inside today and it seems like it’s pretty empty in there again.

So body. What’s next? Do you think we can get back on track?

Here’s a little play by play I’d like you to follow. Don’t worry, this month is a practice run. I understand that you haven’t run this play in nearly three months and you need time to make sure everyone is back on board.

Here’s the strategy: You send out an army led by the Captain FSH (you know, the follicle stimulating hormone). FSH usually works with Sergeant LH (the luteinizing hormone) and in the past have been pretty effective at stimulating the ovaries.

Sergeant LH should know when to call in Admiral Estrogen and Private Progesterone who will tell the uterine lining to prepare it’s self for implantation. Make sure the Private knows to tell the uterus not to panic. It’s not getting a tenant for at least another month. This is just a drill.

You got this so far? Good. Let’s move on.

The ovaries should wait for the command from Sergeant LH and Admiral Estrogen and when cued, should fire off a mature egg.

The mature egg should march down into the fallopian tube and into the uterus. I’m sorry to say that none of my husband’s friends will be joining the egg so she is going to have to take one for the team. Give the uterus about two weeks. It will get direction from Admiral Estrogen and Private Progesterone to shed it’s lining.

That’s it. Not too difficult, right? Hopefully, everyone remembers what to do. I’ll be waiting out here.